Laserfiche WebLink
4 _ <br /> Environmental Health Department <br /> —COUNTY— <br /> `:c.oa<�Y Greatness grows here. <br /> Monitoring Well/Soil Boring Inspection Report <br /> Date:'. �`Aw6nspector p CONSTRUCTION <br /> Facility Address: <br /> Well Address: Total Depth: <br /> WP# \vQ V� Wu_V�,\ Well#: Drilling Rig Type: <br /> Soil Boring#: V'L— 10 <br /> Drilling Company: Min 2" Annular EHD Seal Verified: ❑ Yes ❑No <br /> Driller Onsite: jl��� i(,L Sv,`Screen Length From: To: <br /> Consultant: `�`��p `� Filter Pack From: To: <br /> Geologist: �;r,�f Z.N J_3 Bentonite From: To: <br /> Grout From: To: <br /> Public Water System Onsite: ❑ Yes ❑No COMPLETION ❑ Stove Pipe []Christie Box <br /> Domestic Well Onsite: ❑ Yes ❑No casing <br /> If yes, location and distance: height <br /> SAMPLING ABOVE-GROUND <br /> Holding Temperature: COMPLETION OOMPt=.ON <br /> Method: Ground S"ri'c' "+"— <br /> Screening Method: grout <br /> Verified Chain of Custody: ❑ Yes El No �---ft• <br /> ft. <br /> ft. <br /> SPOILS - <br /> Contamination Noted: ❑ Yes El No — <br /> If yes, spoils storage Location: atoned <br /> aeon :.: — <br /> Covered: ❑ Yes ❑Now <br /> If yes, material: <br /> GROUTING or DESTRUCTION Total Depth: : =_ <br /> Depth to Water: ft• _ ft- <br /> Grout Material: MATERIALS/DEVELOPMENT <br /> Gallons of Grout Used: <br /> Casing Type: <br /> ❑Well Installation ❑Well Destruction Blank Feet Screen Feet <br /> ❑Boring Installation ❑Boring Destruction Slot Size: <br /> Bags of Cement: <br /> METHOD USED Bags Sand/Gravel: <br /> Type/Brand of Bentonite: <br /> ❑Pressure Grout []Over Drill <br /> Filter Pack Type/Size: <br /> ❑ Gravity ❑Tremie ❑Other: Type of Method: <br /> Water Cement 471b Water Cement 941b <br /> gallons Bags gallons Bags <br /> Thickest Thinnest #Bags Thickest Thinnest ttBags Bentanite/Cement Mix 3% Mix 5% MIX <br /> 2.5 5 1 5 10 1 Bentonite per 47 Ib 1.41 2.47 <br /> 5 10 2 10 20 2 Bentonite per 94 lb 2.82 4.7 <br /> 7.5 15 3 15 30 3 <br /> 10 20 4 20 40 4 <br /> 12.5 25 5 25 50 5 <br /> 15 30 6 30 60 6 <br /> 17.5 35 7 35 70 7 <br /> 20 40 8 40 80 1 8 <br /> 10/16/2017 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www._sicehd.com <br />